Neuromuscular release (including myofascial trigger point) (hereinafter generally referred to as “trigger point”) therapy is a method of treating pain that is popular and gaining in popularity; it is commonly used by physical and massage therapists, osteopaths and chiropractors to treat musculoskeletal pain. It comprises the sustained pressure of the hand, finger(s), knee, elbow, foot, or tool on a myofascial trigger point (‘trigger point’), a localized and usually exquisitely tender area in a tendon or muscle that “triggers” the pain felt by the sufferer. The location of the trigger point can coincide with the perceived pain, or can be distant (referred pain). When pressure is applied to the trigger point, the perceived pain usually increases in intensity briefly, and then with continued sustained pressure gradually starts to dissipate until it completely disappears. This process usually takes 20 to 90 seconds and is dependent on the intensity and duration of the pain, the depth and acuity of the pressure applied, as well as the familiarity of the sufferer with this form of treatment and the need to actively relax the area, partially by using deep, relaxing breathing. The effect of the pain relief is usually prolonged by the utilization of stretching exercises performed in the muscle-tendon unit involved immediately after the trigger point release intervention, and postural correction exercises aimed at preventing the recurrence of the pain. Repeating this process on a regular basis helps to prevent pain recurrence until ergonomic and postural corrections take effect.
The pain sufferer will also benefit from more frequent use of such interventions. The pain sufferer would do well to use self-treatment tools on a regular basis (daily or every other day) to maintain musculotendinous units in their normal functioning status, rather than being dependent on frequent and expensive visits to a medical professional for formal interventions of this nature.
Conventionally available to permit individuals to self-treat myofascial trigger points are tools, including canes, balls and rollers, board-mounted probes, and hand-held probes.
Canes are used to apply pressure to a trigger point and most areas of the body are accessible by the user. However, the user must apply pressure to the point with sufficient pressure to “release” the trigger point, but also within comfort levels, while simultaneously relaxing the area being treated. This can be a difficult process, particularly when treating areas in or around the upper extremities which are being used to exert the force. In some cases, a cane can be used as a lever; the user would lie on the tip of the cane and then rotate the handle to apply force at the tip into the trigger point. In this instance, the user still needs to apply exertion to the tool to effect the desired pressure, which can be neurologically confusing, since the user is attempting to relax the area (a process of inhibiting neural activation at the level of the spinal cord) while exerting force (a process of stimulation at the level of the spinal cord). Canes are bulky and unwieldy instruments and are conspicuous in professional or office situations. Only a few of the uses of the cane are intuitive, and the user is reliant on an owner's manual to learn to use the cane to treat difficult-to-reach places. Commercially available canes include the Thera Cane™, The BackKnobber™ and The Body Back Buddy™.
Balls and rollers have a broad contour, which can be sub-optimal in reaching a specific trigger point and it can be difficult to modulate the intensity of the pressure applied to the trigger point. Various balls including tennis, golf, lacrosse and racket balls are used. Commercially available balls include the Trigger Point Massage Ball™ and the Myo-Therapy Ball™. Commercially available bands include the Trigger Point Quadroller™. When desiring to penetrate deeper into the area of a trigger point, the sufferer would look to use a larger ball, which in turn has a larger contour. The dilemma of using a ball therefore results in a decision regarding depth and acuity, and the sufferer cannot have both with this choice.
Hand-held probes are effective in treating pain using the myofascial trigger point release techniques but, for self-treatment, certain areas of the body are difficult or impossible to reach effectively, rendering the user dependent on a helper, or frustrated at being unable to adequately reach an awkward area. In addition, in similar fashion to the cane, self-treatment may require one set of muscles to be activated (to apply the pressure) while the sufferer is simultaneously attempting to relax the affected area. This is particularly difficult when the muscle groups are in close proximity, as described above. This often leaves the user frustrated at the inadequacy of the tool, which is unfortunate since it is rather the circumstances of the tool's use that is inadequate. Some hand-held probes can be used to relieve pain with the user lying on the probe. However, the probe's height and angle and, depending on the design of the tool, the contour are fixed and, as a result, the probe may be too high or low, too large or small, or at an inconvenient angle relative to the trigger point being treated, especially when pressure is applied to the thin muscle overlying the ribs in a lean user, or to the occiput. Commercially available probes include the Hand-L™, the Jackknobber™ and the Knobbler™.
The board mounted systems comprise a platform and rubber tips covering various lengths of dowel that can be inserted into the board at varying angles. This affords the user the ability to select the number, angle, position and height of the probe(s). The probes have various contours (diameter of the probe). Board devices are cumbersome and conspicuous and the many and varied choices of operation can be daunting and confusing. People who have used these systems have commented favorably about the benefit of being able to lie on the device without exerting force, thereby enhancing the relaxation effects of the tool. Commercially available systems include: the Fenix Rehab System™ and the Recapitulator™.
However, there remains a need for a trigger point therapy device, system and method that allows an individual the ability to self-treat trigger points completely independently in a fashion that fosters complete relaxation, as may be the case when the user is able to lie on or lean against the tool or device, which provides the user simple choices in terms of size and height, and which is easily transported and used in conspicuous areas, such as in an office.